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49
"The efficiency of the organisation was well demonstrated a few years ago. Early in 1924
an unusual number of absences from school on account of ' external eye disease ' was reported by
the attendance officers in the Thames-side districts of Poplar and Stepney. A batch of the
affected children was brought to the consultation centre at the head office. I found them to be
suffering from early and acute trachoma. Thereon all absentees and the other children of their
families, and also the children of the schools they had attended, were medically inspected. A
definite epidemic of trachoma was discovered among the children of a few schools in the poorest
quarter close to the docks. Ordinarily cases of trachoma average a score a year for the whole
school population of London. In this year, 1924, the numbers seen were : January, none; February,
none ; March, 17 ; April, 34 ; May, 51 ; June, 36 ; July, 51 ; August, 2 ; September, 4 ;
October, 4; November, 10; December 6; making a total of 215 cases. The affected children
were transferred for treatment to the Swanley Ophthalmia School, now under the direction of
Stephen Mayou, with the most satisfactory results. The epidemic was confined to the original
area of its outbreak, and ceased at the end of the year. I have heard some hard sayings about
the school attendance officer. It has been asserted he is as hard-hearted as the pedagogue of
a familiar Pauline argument; but his strictness is an invaluable safeguard to the children, as
was demonstrated in this outbreak. Imagine what might have happened in densely populated
London if there had been no inquisitorial attendance officer."
The bulk of the investigation into the ophthalmia at the orphanage and the
residential school to which reference has been made was carried out by Dr. J.
Hamilton Mcllroy, who has made the following report:—
As the result of the discovery of several cases of trachoma, Mr. Bishop Harman
suggested an inspection of all children in these two institutions, for the purpose of
detecting all cases of true or suspected trachoma. Drs. McVail and Mcllroy visited the
orphanage on 25th October, 1929. The medical officer and the school nurse were
present and offered every facility for the inspection.
Dr. J.
Hamilton
Mcllroy s
report.
The
Orphanage.
All the children in attendance, boys 210, girls 150, were inspected and a list was
made of those suffering from any form of conjunctival disease. This list comprised
53 boys and 40 girls. Of these, 6 boys and 12 girls showed signs of granular conjunctivitis
suggestive of trachoma and were referred to Mr. Bishop Harman at the
County Hall. Only one boy and one girl were considered by Mr. Bishop Harman to
have trachoma, and were sent to the White Oak Hospital, Swanley. The boy
remained at Swanley until June, 1930. On his return he suffered a relapse and attended
the Belgrave Children's Hospital. He was re-admitted to school in December cured,
but to prevent relapse was given daily treatment.
The girl, who was sent to Swanley remained there until 18th February, 1930,
when she returned to school. She relapsed, however, and Mr. Bishop Harman again
sent her to Swanley. She was re-admitted to school in July, 1930, cured. She was
kept under observation until 14th November without relapse.
Of the other cases on the list none was excluded from school, but all were asked
to attend at the County Hall at periodic intervals to see Mr. Bishop Harman and
were advised rigorous daily treatment. They all improved very much and were
gradually released from attendance. Their condition at the date of the last inspection
(4th December, 1930), was as follows:—
3 boys, 1 girl still on treatment (once daily).
2 boys, 6 girls to be kept under observation.
2 girls discharged cured.
1 boy, 3 girls had left school.
The list of cases (40 boys, 53 girls) showing conjunctival disease was given to
the school authorities. The school nurse retained a copy for her own use and treatment
as indicated for each child was carried out: six re-inspections (mainly by
Dr. Mcllroy) at frequent intervals were made of the children on this list.
At the date of the last visit (4th December, 1930) the list comprised in all 76
cases (41 boys and 35 girls), but 60 of these (31 boys and 29 girls) were under observation
only. Of the 16 under treatment only one case (girl) was of sufficient severity
to require treatment twice daily, i.e., the institution had become almost clear of
active eye trouble.
During the course of the last three inspections a re-inspection of the whole school
took place. A few cases discovered amongst these re-inspections, together with
some cases occurring amongst new admissions account for the increased numbers
towards the end of the period of enquiry.